A patient with severe COVID-19 was successfully rescued by Hubei Aid Shanghai Medical Team and Shanghai No.9 Hospital.
■ Our reporter Tang Wenjia
"An 81-year-old male patient was transferred to the Municipal Public Health Center on May 2, and was diagnosed as COVID-19’s common type when he was admitted to the hospital. However, the basic disease was severe. The patient had cardiac insufficiency, coronary atherosclerotic heart disease, coronary stent implantation history, persistent atrial fibrillation, a small amount of pleural effusion, hypoproteinemia, etc., and he was not vaccinated with COVID-19 vaccine. At present, he has multiple organ failure & HELIP; …” At 7: 30 last night, with Dr. Zhang Yuanhui, who was stationed by Yueyang Hospital in Shanghai Public Health Clinical Medical Center, telling an elderly COVID-19 patient’s condition online, a "night consultation" of experts in traditional Chinese and western medicine on difficult or critical cases in COVID-19 began.
Since the outbreak of this epidemic, the treatment of critically ill patients has touched people’s hearts. The city adheres to the principle of "four concentrations", that is, concentrating patients, experts, resources and treatment, especially for severe treatment. The reporter learned from the Shanghai Municipal Health and Health Commission that at present, the city has co-ordinated medical resources and established a comprehensive treatment expert group of more than 500 people, docking with experts from designated hospitals, sinking experts and focusing on strengthening the ability of severe treatment. The team who fought in the front line of critical care said that they would unswervingly adhere to the general policy of "dynamic clearing", fully and thoroughly implement the requirements of "four applications and four exhausts", go all out to invest in treatment, and go all out to win the battle of defending Shanghai.
"Pay equal attention to the three", make every effort to improve the cure rate and reduce the death rate.
"From the situation of this 81-year-old patient, it can be seen that his COVID-19 is not heavy, but the basic disease is intractable and life-threatening." In the consultation of Chinese and Western medicine last night, Yan Shiyun, a famous Chinese medicine practitioner and former president of Shanghai University of Traditional Chinese Medicine, gave such a judgment.
Zhang Wenhong, head of the expert group of medical treatment in COVID-19 and director of the infectious diseases department of Huashan Hospital, also said during the consultation that the fever of this elderly patient was complicated, COVID-19 infection was intertwined with basic diseases, and the systemic inflammatory response syndrome induced by COVID-19 infection brought a heavy blow to the body. "The daily rounds of traditional Chinese medicine have given many useful suggestions to the treatment group, ‘ One person and one party ’ It helps to provide patients with better treatment strategies. "
Since the outbreak of this epidemic, the "night consultation" of COVID-19’s severe cases of traditional Chinese medicine has never stopped. Under the guidance of state administration of traditional chinese medicine, the Shanghai Administration of Traditional Chinese Medicine organized and invited experts of Chinese medicine and western medicine from China and Shanghai to carry out joint case discussion on critical cases in COVID-19. There was a heated discussion in the remote video conference room. In addition to the first-line team of the designated hospital in Shanghai, Yan Shiyun discussed on the same screen with famous Chinese medicine experts such as China Academy of Engineering and Zhang Boli, head of the Chinese medicine expert group of the National Shanghai Working Group. The high-standard expert configuration was only to provide better treatment and protection for critically ill patients.
The reporter learned from the Municipal Health and Health Commission that at present, the city has established 44 designated hospitals in the urban area and opened 25,000 beds for treatment. As of 24: 00 on May 5th, 526 patients with severe illness and 95 patients with critical illness were treated in the designated medical institutions in COVID-19. Designated hospitals in COVID-19 are the last line of defense to protect the lives of critically ill patients. To this end, the city adheres to the three principles of "paying equal attention to the treatment of basic diseases in COVID-19, paying equal attention to the prevention of light to heavy treatment and paying equal attention to the treatment of severe diseases, and paying equal attention to the treatment of traditional Chinese and western medicine" to improve the cure rate and reduce the death rate.
Facing the challenge of critical care, linkage of designated hospitals in urban areas
There are nearly 600,000 local epidemic victims in Shanghai this round, and the emergence of people infected with various basic diseases further challenges the difficulty of severe and even critically ill treatment.
"Nurse, my chest hurts and I can’t breathe." On the afternoon of May 5th, an unexpected situation occurred in the designated hospital in the southern campus of Renji Hospital: a COVID-19 patient suffered from chest pain during hemodialysis, and the nurse in the hemodialysis room immediately contacted the Department of Cardiology. After consultation with experts such as Gu Leyi, director of Nephrology Department of Renji Hospital, and Zang Minhua, chief physician of Cardiology Department, it was judged that this was an acute inferior ST-segment elevation myocardial infarction, which was life-threatening at any time!
The medical staff immediately performed PCI for patients with acute myocardial infarction, and the whole operation was completed within 90 minutes, which fully met the standard of chest pain center.
At present, the patient’s vital signs are stable and will be transferred back to the general ward.
The successful completion of acute myocardial infarction surgery is due to the emergency plan for special diseases set by designated hospitals, and multidisciplinary emergency treatment is on the right track. Since it was transferred to a designated hospital on April 7th, the South Campus of Yan Chai Hospital not only accepts COVID-19 patients complicated with basic diseases, but also undertakes serious patients from the two major cabins of World Expo and New China Expo, as well as designated hospitals in Pudong New Area and Xuhui District every day.
Therefore, at 2 pm every day, in the conference room of the hospital, Professor Xia Qiang, the president of Yan Chai Hospital and the head of the expert group of the designated hospital in the southern campus, sat in the town online, and a consultation group composed of experts from critical medicine, emergency department, respiratory department, cardiology, surgery, anesthesiology, infection department, neurology department and nephrology department discussed the critical cases and formulated "one person, one policy".
"Centralized case discussion also plays the role of early warning of critical illness and early screening of key patients, effectively ensuring the rate of severe treatment." The reporter learned from Yan Chai Hospital that since March, the Shanghai Geriatrics Center, Zhou Pu Hospital and the South Hospital of Yan Chai Hospital have been successively turned into designated hospitals, and the medical team during their stay worked together to save their lives again and again.
The reporter learned from the Municipal Health and Health Commission that the city has established a linkage and cooperation mechanism between municipal-level designated hospitals and 16 district-level designated hospitals to provide personnel and technical support for district-level designated hospitals and further improve the level of severe treatment.
Shanghai medical staff and medical teams assisting Shanghai fight side by side to escort more lives.
In the process of severe treatment, the figure of Shanghai medical staff and the medical team assisting Shanghai working together is particularly touching. Recently, the medical team of Hubei Aid to Shanghai and the medical staff of Shanghai Ninth People’s Hospital successfully rescued a severe COVID-19 patient with hepatitis C cirrhosis, liver cancer, portal hypertension and gastrointestinal bleeding.
Late at night on April 25th, a 57-year-old critically ill patient from COVID-19 was admitted to the ICU of the designated hospital of No.9 Hospital. He suffered from hemorrhagic shock due to massive gastrointestinal bleeding. Among the medical teams assisting Shanghai in Hubei, the first medical team of ICU led by Wei Dai, deputy chief physician from Wuhan First Hospital, immediately organized rescue. After a series of emergency measures, the patient’s vital signs tend to be stable.
In order to make the patients receive meticulous treatment and care, Wei Dai and the medical staff from the First Hospital of Wuhan, the Fourth Hospital of Wuhan and the Ninth Hospital of Shanghai assessed the patients’ condition in detail, worked out a careful treatment plan and cooperated with each other. Everything comes to him who waits. On May 1st, the patient’s COVID-19 nucleic acid test was negative twice in a row, reaching the discharge standard, and was successfully cured and discharged.
"Don’t give up any critically ill patients in COVID-19." This is a sentence written by the treatment team to the reporter. Since April 18th, the first batch of COVID-19 patients have been admitted. Up to 22: 00 on May 5th, the designated hospital in the North Hospital of the Ninth Hospital has admitted 1,502 patients, including 768 patients aged 70-89, 151 patients over 90 years old and 1,502 people using Chinese medicine. Among the patients admitted, there were 4 centenarians, the oldest being 104 years old, who were cured and discharged on April 28th, and a 102-year-old patient was cured and discharged on May 3rd.
Wu Hao, president of Shanghai Ninth People’s Hospital, said that most of the patients admitted to the designated hospitals are elderly people and patients with various basic diseases, and the treatment difficulty and work intensity are far greater than expected. In order to further improve the ability of severe treatment, the hospital further enriched the treatment team on May 1 based on the first echelon medical team, and further improved the ability of severe treatment with the principle of "centralized treatment and critical subdivision".
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